Tantalus and the Tyranny of Territory: Pursuing the dream of parity in rural and metropolitan population health outcomes through primary health care programs

2004 ◽  
Vol 10 (3) ◽  
pp. 83 ◽  
Author(s):  
Peter Harvey
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rural Communities ◽  
Health Outcomes ◽  
Rural Health ◽  
Rural Areas ◽  
Access To Health Care ◽  
Fundamental Problem ◽  
Primary Health ◽  
Rural And Urban

Many health professionals and rural health academics are motivated by the challenge of achieving equitable access to health care in rural communities with the implicit vision that fairer access to services might ultimately lead to more equitable health outcomes for people living in rural and remote settings. The purpose of this paper is to put the issue of rural and urban health outcome parity into perspective and assess recent progress towards achieving the ultimate goal of improving rural health status. I will also explore ways in which rural communities might increase their access to and use of primary health care revenue in the future to improve community health outcomes. While some improvements have been achieved across the rural health system in recent times, the fundamental problem of maintaining infrastructure to service community needs in rural areas remains as daunting as ever. Extensive evidence has now been assembled to show that rural people generally enjoy a much lower standard of health care, health outcomes and life expectancy than their urban cousins. The question underlying all of this evidence, however, is... must this always be so? Is it possible to redress the current inequities between rural and urban populations and could new primary health care initiatives, such as the Enhanced Primary Care (EPC) program, be vehicles for achieving more equitable health care arrangements and health outcomes for people living in rural communities?

scholarly journals Patients' Satisfaction with Primary Health Care in Egypt: Exploring the Gap between Rural and Urban Governorates

2014 ◽  
Vol 5 (4) ◽  
pp. 221-230
Author(s):  
Dina Metwally
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Rural Areas ◽  
Health Care Services ◽  
Care Providers ◽  
Registration System ◽  
Patients Satisfaction ◽  
Primary Health ◽  
Rural And Urban

Patient satisfaction has been frequently used as an indication of the overall quality of health care providers. Understanding patients` needs and expectations is crucial to PHC providers to improve patients` health. This study aims to explore patients' satisfaction with primary health care services in urban and rural areas in Egypt. The study shows a gap in patient`s satisfaction across Alexandria and Sohag governorates. This implies a difference in reform implementation across urban and rural governorates. More attention should be given to different dimensions of health care provision at PHC level in rural governorates including clinical and nonclinical training of nurses, improvement in amenities and other facilities, improvement of registration system, and promoting the new system.

scholarly journals Assessment of primary laboratory facilities for rural health care preparedness in Osmanabad District, India

2019 ◽  
Author(s):  
Rahi Jain ◽  
Bakul Rao
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Status ◽  
Rural Health ◽  
Rural Health Care ◽  
Rural Areas ◽  
Public Health Response ◽  
Primary Health ◽  
Laboratory Services

Government of India has provided Indian Public Health Standards to improve rural health care services and health status, but still rural laboratory is a cause of concern. This study is performed to understand the laboratory facility-level gaps that need to be addressed to improve the public primary health centers (PHCs) present in rural areas. The laboratory assessment is performed for governance, financing, resources and services and results are validated with the PHC laboratory performance. The current assessment shows critical gaps in the facilities regarding governance, services, resources and financing required for the laboratory services at the rural primary health care level. Governance and services need to be strengthened the most followed with sustained availability of resources and financing. Poor health status in rural areas necessitates public health response based on health systems. Therefore, health system preparedness in terms of laboratory services are essential in primary health care facilities.

scholarly journals Zimbabwe's New Diploma in Psychiatric Health

1983 ◽  
Vol 7 (4) ◽  
pp. 69-71
Author(s):  
W. Murdoch
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Communities ◽  
Medical School ◽  
Rural Areas ◽  
Medical Services ◽  
Specialist Care ◽  
Primary Health

Psychiatry in a land of 7 1/2 million (National Census, August 1982) people with relatively advanced general medical services, but only eight psychiatrists, has great problems. The facilities have been described elsewhere (Murdoch, 1982). Historically poorly related to population needs, and with immense difficulties in serving the rural communities that still comprise over half the population (National Census), Zimbabwe has concentrated its post-independence effort on the development of primary health care in village, district and small town. With a medical school expanding (current intake 80 students per annum) and good central facilities for training and specialist care, primary care in public health and general medical services are developing on a sound basis. In psychiatry, a mere 1200 beds for the country (only 141 in the capital, Harare, which, with dormitory towns, has an ‘official’ population of 1.1 million and serves a further four million in remote rural areas) the training and specialist facilities are sketchy indeed.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

scholarly journals Prevention and Control of COVID-19 by Primary Health Care Facilities in China: A Field- Survey-Based Qualitative Study in Three Typical Cities

2021 ◽  
Author(s):  
Yunyun Yan ◽  
Teng-yang Fan ◽  
Yan-ling Zheng ◽  
Hai-qin Yang ◽  
Tian-shu Li ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Rural Areas ◽  
Prevention And Control ◽  
Field Survey ◽  
Risk Levels ◽  
Face To Face ◽  
Primary Health ◽  
Community Residents ◽  
And Control

Abstract Background In fulfilling the COVID-19 containment, primary health care (PHC) facilities in China played an important role. We sought to investigate the exact tasks performed at the PHC facilities and the processes of COVID-19 prevention and control.Methods Semi-structured face-to-face interviews for primary care physicians (PCPs) and a simple survey for residents were conducted in the field survey. Based-on purposive stratified sampling, 32 PCPs were selected from 22 PHC facilities in Wuhan as a high-risk city, in Shanghai as medium-risk city and in Zunyi as low-risk city. In the field survey, semi-structured face-to-face interviews were conducted with PCPs to summarize the tasks of COVID-19 prevention and control at the PHC facilities. A simple survey was used to investigate the local residents’ awareness about COVID-19 prevention and control.Results In pre-outbreak period, the PHC facilities mainly engaged in storing medical supplies; in out-break period, they were responsible for screening, transferring, quarantine and treatment; in regular prevention and control period, attention was given to the employees and items of cold-chain & fresh food markets, etc. In Wuhan, PHC facilities focused on graded diagnoses and treatments of patients; in Shanghai, they were mainly engaged in at-home/centralized quarantine; in Zunyi, they focused on the screening of high-risk individuals. In urban areas, COVID-19 were more likely to be transmitted; in urban-rural areas, it was difficult to perform screening on the migrant populations; in rural areas, the risk was much lower. The community residents had satisfactory compliance with the preventive measures.Conclusion We identified differences in the prevention and control tasks performed at the PHC facilities in China. During the different phases of the pandemic, the tasks were adjusted depending on the gradually comprehensive understanding of COVID-19. Among the cities at different risk levels, screening, quarantine, transferring or treatment was chosen to be a priority accordingly. Located in different intra-city geographic locations at different risk levels, the PHC facilities conducted their own tasks accordingly. Additionally, compliance on the part of the local community residents could not be overemphasized in COVID-19 prevention and control.

scholarly journals The impact of COVID-19 on primary health care and antibiotic prescribing in rural China: qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Areas ◽  
Rural China ◽  
Antibiotic Prescribing ◽  
Epidemic Control ◽  
Primary Health ◽  
Tract Infections ◽  
The Impact

Abstract Background In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. Methods Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. Results PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. Conclusions The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.

Access to cataract services in selected rural communities in South Africa

2019 ◽  
Author(s):  
Lunic Base Khoza ◽  
Wilfred Njabulo Nunu ◽  
Bumani Solomon Manganye ◽  
Pfungwa Mambanga ◽  
Shonisani Tshivhase ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Rural Communities ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Services ◽  
Secondary Data ◽  
Demographic Characteristics ◽  
Outcome Variable ◽  
Patient Records

Abstract Background Despite government efforts to improve access to health care services through the re-engineered Primary Health Care and National Health insurance platform, access still remain a challenge particularly in rural areas. The aim of this study was to analyse secondary data on cataract patients who were attended to in selected hospitals in rural Limpopo of South Africa. Methodology A cross section survey was conducted on 411 patient records from five selected hospitals in Vhembe district. A pre tested structured checklist was used to guide retrieval of variables from patient records. The collected data was entered into excel spreadsheet, cleaned and imported into Statistical Package for Social Sciences version 26 for analysis. Proportions of demographic characteristics were presented and these were cross tabulated with the outcome variable “success of operation” using Chi Squared tests. Results Findings point out that majority of patients who attended hospital for eye services were aged 65 years above and females (63%). There was no association between the tested demographic characteristics and the outcome variable. Most patients were diagnosed in the period 2015-2018 (60%). Over 90% of those that were operated had successful operations. Of the remaining 10% that had unsuccessful operations, 30% cited complications as being the reason why these operations were unsuccessful. Conclusions It is evident from the findings that cataract services offered in rural areas have low impact as they are not accessible to the patient. It is critical to have a worker retention strategy to retain experts.

scholarly journals Hope for the Best, Prepare for the Worst—An Assessment of Flood Preparedness at Primary Health Care Facilities in Central Vietnam

2018 ◽  
Vol 15 (12) ◽  
pp. 2689 ◽  
Author(s):  
Andreas Älgå ◽  
Thi Dang ◽  
Dell Saulnier ◽  
Gia Nguyen ◽  
Johan von Schreeb
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Access To Health Care ◽  
Monsoon Season ◽  
Health Care Facilities ◽  
Validity And Reliability ◽  
Primary Health ◽  
Central Vietnam ◽  
Flood Preparedness ◽  
Flood Experience

Background: Floods affect over 85 million people every year and are one of the deadliest types of natural disasters. The health effects of floods are partly due to a loss of access to health care. This loss can be limited with proper flood preparedness. Flood preparedness is especially needed at the primary health care (PHC) level. Flood preparedness assessments can be used to identify vulnerable facilities and help target efforts. The existing research on PHC flood preparedness is limited. We aimed to assess the flood preparedness of PHC facilities in a flood-prone province in central Vietnam. Methods: Based on flood experience, the PHC facilities in the province were grouped as “severe” (n = 23) or “non-severe” (n = 129). Assessments were conducted during monsoon season at five facilities from each group, using a pre-tested, semi-structured questionnaire. Data were checked against official records when possible. Results: Nine of the ten facilities had a flood plan and four received regular flood preparedness training. Six facilities reported insufficient preparedness support. Half of the facilities had additional funding available for flood preparedness, or in case of a flood. Flood preparedness training had been received by 21/28 (75%) of the staff at the facilities with severe flood experience, versus 15/25 (52%) of the staff at the non-severe experience facilities. Conclusions: Our results suggest that the assessed PHC facilities were not sufficiently prepared for the expected floods during monsoon season. PHC flood preparedness assessments could be used to identify vulnerable facilities and populations in flood-prone areas. More research is needed to further develop and test the validity and reliability of the questionnaire.

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